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Contemporary Concepts of Primary Dynamic Facial Nerve Reconstruction in the Oncologic Patient

Klein, Holger Jan MD*,†; Guedes, Tiago MD; Tzou, Chieh-Han John MD§; Rodriguez-Lorenzo, Andrés MD, PHD*

doi: 10.1097/SCS.0000000000005619
Technical Strategies

Transection of the facial nerve and its branches during extensive ablative procedures in the oncologic patient causes loss of control of facial mimetic muscles with severe functional and aesthetic sequelae. In such patients with advanced tumorous disease, copious comorbidities, and poor prognosis, rehabilitation of the facial nerve has long been considered of secondary priority. However, recent advances in primary facial nerve reconstruction after extensive resection demonstrated encouraging results focusing on rapid and reliable restoration of facial functions. The authors summarize 3 innovative approaches of primary dynamic facial nerve reconstruction by using vascularized nerve grafts, dual innervation concepts, and intra-facial nerve transfers.

*Department of Plastic and Maxillofacial Surgery, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden

Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland

Department of Plastic, Reconstructive and Craniomaxillofacial Surgery and Microsurgery Unit, Vila Nova de Gaia/Espinho Hospital Centre, Porto, Portugal

§Faculty of Medicine, Sigmund Freud University, Vienna, Austria.

Address correspondence and reprint requests to Holger Jan Klein, MD, University Hospital Zurich, Division of Plastic Surgery and Hand Surgery, Raemistrasse 100, 8091 Zurich, Switzerland; E-mail:

Received 17 February, 2019

Accepted 21 March, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.